Simple Febrile Convulsion

Febrile convulsion
the most common seizure disorder during childhood 3 month - 6 yr of age strong family history of febrile convulsion

Simple Febrile convulsion

     

Complex Febrile Convulsion

  

Temperature of 37.8C or greater generalized and tonicclonic seizure Lasts for less than 15 minutes Not recur within the same febrile illness Neurologic examination is normal No underlying CNS infection

duration is >15 min repeated convulsions occur within 24 hr focal seizure activity or focal findings are present during the postictal period

Definition
Grades of Recommendation Grade A: Diagnostic test should be used Grade B: The test may or may not be used Grade C: The test should not be used

Diagnosis of Febrile Convulsion

RECOMMENDATION ON NEURODIAGNOSTIC PROCEDURES
 

Lumbar puncture should be performed in all children below 18 months for a simple febrile seizure. For children more than 18 months of age, lumbar puncture should be performed in the presence of clinical signs of meningitis

Grade of Recommendation: A Level of Evidence 3

RECOMMENDATION ON NEURODIAGNOSTIC PROCEDURES

ACCURACY OF TEST Children with febrile seizures, lumbar puncture for CSF analysis is performed to rule out meningitis CSF analysis is the gold standard for diagnosis of meningitis Spinal fluid examination is not a test that makes a diagnosis of febrile seizures per se Major signs of meningitis Nuchal rigidity Coma Petechiae Minor signs of meningitis  Persisting drowsiness  Paralysis on examination

RECOMMENDATION ON NEURODIAGNOSTIC PROCEDURES

Neuroimaging studies (cranial ultrasound, CT scan, MRI) should not be routinely performed in children for a simple febrile seizure No study has been done investigating the utility of neuroimaging in children with simple febrile seizure

Grade of Recommendation: C Level of Evidence: 4

Treatment of Febrile Convulsion

RECOMMENDATION ON THERAPEUTIC INTERVENTION  Antipyretic agents are used to control fever and not be relied upon to prevent recurrence There is little evidence that prophylactic use of antipyretics has any effect in reducing the incidence of febrile convulsion Acetaminophen(10 mg/kg/dose) and ibuprofen (5 mg/kg/dose) are effective antipyretic agents Little evidence that use of antipyretics has any effect in reducing the incidence of febrile convulsion Grade of Recommendation: C Level of Evidence: 2

RECOMMENDATION ON THERAPEUTIC INTERVENTION



Use of continuous anticonvulsant is not recommended in children after a first simple febrile seizure.
Although anticonvulsants can reduce recurrence of febrile convulsion, the adverse side effects of these do not warrant their use in this benign disorder

Prognostic Evaluation
Electroencephalogram should not be routinely requested in children with a first simple febrile convulsion


Evidences show that it does not reliably predict recurrence of febrile seizure